Job Description

Position Title: Outpatient Scheduling Representative

Position Purpose:

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country.

This position is responsible for financially clearing all outpatient referrals as ordered by the referring provider. Financial clearing includes but not limited to, validating the order (following protocols designed by the departments the order is referred too), checking medical necessity, verifying insurance eligibility, obtaining authorization (when necessary), scheduling procedures/visits, pre-registration, communicating financial responsibility to patient, scanning documents, and noting all communication into patient chart.

Key Responsibilities

Outpatient Scheduling Representative:

1. Develops and maintains positive interactions with patients, visitors, medical staff, and employees, in accordance with KHI mission, vision, and values.
2. Protects patient information and hospital financial reimbursement by updating demographic information, verifying insurance information, and ensuring that all notification/authorizations are complete according to department policy and procedures.
3. Accurately pre-registers patients and consistently meets accuracy expectations of 98%.
4. Accurately validates orders per scheduling guidelines and verifies diagnosis codes are appropriate for ordered procedures.
5. Schedules procedures/visits in the appropriate area (department, imaging modality room, KHI location).
6. Utilizes designated tools and resources as directed (i.e. electronic medical record, AIDET, etc.).
7. Meets designated productivity standards to schedule cleared outpatient visits in a timely manner.
8. Works to increase upfront collections by communicating to the patient their co-pays/deductibles and documenting that information to secure collection.
9. Consistently demonstrates a willingness to assist co-workers in a courteous manner to support department efficiency.
10. Completes all assigned duties accurately and in a timely manner.
11. Ability to communicate effectively with others, to manage multiple priorities and tasks, to maintain attention to detail.
12. Knowledge of and ability to use computer hardware and software applications.
13. Knowledge of medical terminology, coding rules and guidelines preferred.

Lead Outpatient Scheduling Representative: In addition to above key responsibilities of an Outpatient Centralized Scheduling Representative, a Lead Outpatient Centralized Scheduling Representative:

• Provides day to day leadership and supervision of scheduling team members, trains, and orients new hire schedulers and works with Supervisors to provide continuous training of existing staff.
• Performs QA audits, works account checks, and responds to account denials.
• In the absence of the supervisor the Lead Outpatient Scheduling Representative assists with the scheduling of staff to ensure appropriate coverage.
• Participates in the interviews for hiring new staff within the unit, as well as provides feedback to the supervisors for performance evaluations.
• Identifies, supports, and manages process improvement initiatives for the team.
• Collaborates with management to assist in the day-to-day operations of the team.

Qualifications

• Education: High school graduate/GED or 2-5 years healthcare experience in lieu of education requirement.
• Experience: Six months or more of progressive work experience

Preferences: Experience: One year of hospital outpatient scheduling and/or insurance verification experience in a hospital setting.

Date Staff Position Description Created / Revised: 11/14/2019; 10/02/2020; 8/5/2024; 1/30/2026; 6/1/2026